[United States Statutes at Large, Volume 118, 108th Congress, 2nd Session]
[From the U.S. Government Publishing Office, www.gpo.gov]

118 STAT. 1404

Public Law 108-355
108th Congress

An Act


 
To amend the Public Health Service Act to support the planning,
implementation, and evaluation of organized activities involving
statewide youth suicide early intervention and prevention strategies, to
authorize grants to institutions of higher education to reduce student
mental and behavioral health problems, and for other
purposes. NOTE: Oct. 21, 2004 -  [S. 2634]

Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled, NOTE: Garrett Lee
Smith Memorial Act. 42 USC 201 note.

SECTION 1. SHORT TITLE.

This Act may be cited as the ``Garrett Lee Smith Memorial Act''.

SEC. 2. NOTE: 42 USC 290bb-36 note. FINDINGS.

Congress makes the following findings:
(1) More children and young adults die from suicide each
year than from cancer, heart disease, AIDS, birth defects,
stroke, and chronic lung disease combined.
(2) Over 4,000 children and young adults tragically take
their lives every year, making suicide the third overall cause
of death between the ages of 10 and 24. According to the Centers
for Disease Control and Prevention, suicide is the third overall
cause of death among college-age students.
(3) According to the National Center for Injury Prevention
and Control of the Centers for Disease Control and Prevention,
children and young adults accounted for 15 percent of all
suicides completed in 2000.
(4) From 1952 to 1995, the rate of suicide in children and
young adults tripled.
(5) From 1980 to 1997, the rate of suicide among young
adults ages 15 to 19 increased 11 percent.
(6) From 1980 to 1997, the rate of suicide among children
ages 10 to 14 increased 109 percent.
(7) According to the National Center of Health Statistics,
suicide rates among Native Americans range from 1.5 to 3 times
the national average for other groups, with young people ages 15
to 34 making up 64 percent of all suicides.
(8) Congress has recognized that youth suicide is a public
health tragedy linked to underlying mental health problems and
that youth suicide early intervention and prevention activities
are national priorities.
(9) Youth suicide early intervention and prevention have
been listed as urgent public health priorities by the
President's New Freedom Commission in Mental Health (2002), the
Institute of Medicine's Reducing Suicide: A National Imperative

[[Page 1405]]
118 STAT. 1405

(2002), the National Strategy for Suicide Prevention: Goals and
Objectives for Action (2001), and the Surgeon General's Call to
Action To Prevent Suicide (1999).
(10) Many States have already developed comprehensive
statewide youth suicide early intervention and prevention
strategies that seek to provide effective early intervention and
prevention services.
(11) In a recent report, a startling 85 percent of college
counseling centers revealed an increase in the number of
students they see with psychological problems. Furthermore, the
American College Health Association found that 61 percent of
college students reported feeling hopeless, 45 percent said they
felt so depressed they could barely function, and 9 percent felt
suicidal.
(12) There is clear evidence of an increased incidence of
depression among college students. According to a survey
described in the Chronicle of Higher Education (February 1,
2002), depression among freshmen has nearly doubled (from 8.2
percent to 16.3 percent). Without treatment, researchers
recently noted that ``depressed adolescents are at risk for
school failure, social isolation, promiscuity, self-medication
with drugs and alcohol, and suicide--now the third leading cause
of death among 10-24 year olds.''.
(13) Researchers who conducted the study ``Changes in
Counseling Center Client Problems Across 13 Years'' (1989-2001)
at Kansas State University stated that ``students are
experiencing more stress, more anxiety, more depression than
they were a decade ago.'' (The Chronicle of Higher Education,
February 14, 2003).
(14) According to the 2001 National Household Survey on Drug
Abuse, 20 percent of full-time undergraduate college students
use illicit drugs.
(15) The 2001 National Household Survey on Drug Abuse also
reported that 18.4 percent of adults aged 18 to 24 are dependent
on or abusing illicit drugs or alcohol. In addition, the study
found that ``serious mental illness is highly correlated with
substance dependence or abuse. Among adults with serious mental
illness in 2001, 20.3 percent were dependent on or abused
alcohol or illicit drugs, while the rate among adults without
serious mental illness was only 6.3 percent.''.
(16) A 2003 Gallagher's Survey of Counseling Center
Directors found that 81 percent were concerned about the
increasing number of students with more serious psychological
problems, 67 percent reported a need for more psychiatric
services, and 63 percent reported problems with growing demand
for services without an appropriate increase in resources.
(17) The International Association of Counseling Services
accreditation standards recommend 1 counselor per 1,000 to 1,500
students. According to the 2003 Gallagher's Survey of Counseling
Center Directors, the ratio of counselors to students is as high
as 1 counselor per 2,400 students at institutions of higher
education with more than 15,000 students.
SEC. 3. AMENDMENTS TO PUBLIC HEALTH SERVICE ACT.

(a) Youth Interagency Research, Training, and Technical Assistance
Centers.--Section 520C of the Public Health Service Act (42 U.S.C.
290bb-34) is amended--

[[Page 1406]]
118 STAT. 1406

(1) in subsection (a)--
(A) by striking ``Health, shall award grants'' and
inserting ``Health--
``(1) shall award grants'';
(B) by striking the period at the end and inserting
``; and''; and
(C) by adding at the end the following:
``(2) shall award a competitive grant to 1 additional
research, training, and technical assistance center to carry out
the activities described in subsection (d).'';
(2) in subsection (c), in the matter preceding paragraph
(1), by striking ``grant or contract under subsection (a)'' and
inserting ``grant or contract under subsection (a)(1)'';
(3) in subsection (d)--
(A) by striking ``Appropriations.--For the purpose
of carrying out this section'' and inserting
``Appropriations.--
``(1) For the purpose of awarding grants or contracts under
subsection (a)(1)''; and
(B) by adding at the end the following:
``(2) NOTE: Appropriation authorization. For the purpose
of awarding a grant under subsection (a)(2), there are
authorized to be appropriated $3,000,000 for fiscal year 2005,
$4,000,000 for fiscal year 2006, and $5,000,000 for fiscal year
2007.'';
(4) by redesignating subsection (d) as subsection (e); and
(5) by inserting after subsection (c) the following:

``(d) Additional Center.--The additional research, training, and
technical assistance center established under subsection (a)(2) shall
provide appropriate information, training, and technical assistance to
States, political subdivisions of a State, Federally recognized Indian
tribes, tribal organizations, institutions of higher education, public
organizations, or private nonprofit organizations for--
``(1) the development or continuation of statewide or tribal
youth suicide early intervention and prevention strategies;
``(2) ensuring the surveillance of youth suicide early
intervention and prevention strategies;
``(3) studying the costs and effectiveness of statewide
youth suicide early intervention and prevention strategies in
order to provide information concerning relevant issues of
importance to State, tribal, and national policymakers;
``(4) further identifying and understanding causes and
associated risk factors for youth suicide;
``(5) analyzing the efficacy of new and existing youth
suicide early intervention techniques and technology;
``(6) ensuring the surveillance of suicidal behaviors and
nonfatal suicidal attempts;
``(7) studying the effectiveness of State-sponsored
statewide and tribal youth suicide early intervention and
prevention strategies on the overall wellness and health
promotion strategies related to suicide attempts;
``(8) promoting the sharing of data regarding youth suicide
with Federal agencies involved with youth suicide early
intervention and prevention, and State-sponsored statewide or
tribal youth suicide early intervention and prevention
strategies for the purpose of identifying previously unknown
mental health causes and associated risk factors for suicide in
youth;

[[Page 1407]]
118 STAT. 1407

``(9) evaluating and disseminating outcomes and best
practices of mental and behavioral health services at
institutions of higher education; and
``(10) other activities determined appropriate by the
Secretary.''.

(b) Suicide Prevention for Youth.--Title V of the Public Health
Service Act (42 U.S.C. 290aa et seq.) is amended--
(1) in section 520E (42 U.S.C. 290bb-36)--
(A) in the section heading by striking ``CHILDREN
AND ADOLESCENTS'' and inserting ``YOUTH'';
(B) by striking subsection (a) and inserting the
following:

``(a) NOTE: Contracts. In General.--The Secretary shall award
grants or
cooperative agreements to public organizations, private nonprofit
organizations, political subdivisions, consortia of political
subdivisions, consortia of States, or Federally recognized Indian tribes
or tribal organizations to design early intervention and prevention
strategies that will complement the State-sponsored statewide or tribal
youth suicide early intervention and prevention strategies developed
pursuant to section 520E.'';
(C) in subsection (b), by striking all after
``coordinated'' and inserting ``with the relevant
Department of Health and Human Services agencies and
suicide working groups.'';
(D) in subsection (c)--
(i) in the matter preceding paragraph (1), by
striking ``A State'' and all that follows through
``desiring'' and inserting ``A public
organization, private nonprofit organization,
political subdivision, consortium of political
subdivisions, consortium of States, or federally
recognized Indian tribe or tribal organization
desiring'';
(ii) by redesignating paragraphs (1) through
(9) as paragraphs (2) through (10), respectively;
(iii) by inserting before paragraph (2) (as so
redesignated) the following:
``(1)(A) comply with the State-sponsored statewide early
intervention and prevention strategy as developed under section
520E; and
``(B) in the case of a consortium of States, receive the
support of all States involved;'';
(iv) in paragraph (2) (as so redesignated), by
striking ``children and adolescents'' and
inserting ``youth'';
(v) in paragraph (3) (as so redesignated), by
striking ``best evidence-based,'';
(vi) in paragraph (4) (as so redesignated), by
striking ``primary'' and all that follows and
inserting ``general, mental, and behavioral health
services, and substance abuse services;'';
(vii) in paragraph (5) (as so redesignated),
by striking ``children and'' and all that follows
and inserting ``youth including the school
systems, educational institutions, juvenile
justice system, substance abuse programs, mental
health programs, foster care systems, and
community child and youth support
organizations;'';

[[Page 1408]]
118 STAT. 1408

(viii) by striking paragraph (8) (as so
redesignated) and inserting the following:
``(8) offer access to services and care to youth with
diverse linguistic and cultural backgrounds;''; and
(ix) by striking paragraph (9) (as so
redesignated) and inserting the following:
``(9) conduct annual self-evaluations of outcomes and
activities, including consulting with interested families and
advocacy organizations;'';
(E) by striking subsection (d) and inserting the
following:

``(d) Use of Funds.--Amounts provided under a grant or cooperative
agreement under this section shall be used to supplement, and not
supplant, Federal and non-Federal funds available for carrying out the
activities described in this section. Applicants shall provide financial
information to demonstrate compliance with this section.'';
(F) in subsection (e)--
(i) by striking ``, contract,''; and
(ii) by inserting after ``Secretary that the''
the following: ``application complies with the
State-sponsored statewide early intervention and
prevention strategy as developed under section
520E and the'';
(G) in subsection (f), by striking ``, contracts,'';
(H) in subsection (g)--
(i) by striking ``A State'' and all that
follows through ``organization receiving'' and
inserting ``A public organization, private
nonprofit organization, political subdivision,
consortium of political subdivisions, consortium
of States, or Federally recognized Indian tribe or
tribal organization receiving''; and
(ii) by striking ``, contract,'' each place
such term appears;
(I) in subsection (h), by striking ``, contracts,'';
(J) in subsection (i)--
(i) by striking ``A State'' and all that
follows through ``organization receiving'' and
inserting ``A public organization, private
nonprofit organization, political subdivision,
consortium of political subdivisions, consortium
of States, or Federally recognized Indian tribe or
tribal organization receiving''; and
(ii) by striking ``, contract,'';
(K) in subsection (k), by striking ``5 years'' and
inserting ``3 years'';
(L) in subsection (l)--
(i) in paragraph (2), by striking ``21'' and
inserting ``24''; and
(ii) in paragraph (3), by striking ``which
might have been'';
(M) in subsection (m)--
(i) by striking ``Appropriation.--'' and all
that follows through ``For'' in paragraph (1) and
inserting ``Appropriation.--For''; and
(ii) by striking paragraph (2);
(N) by redesignating subsection (m) as subsection
(n); and
(O) by inserting after subsection (l) the following:

[[Page 1409]]
118 STAT. 1409

``(m) Definitions.--In this section, the terms `early intervention',
`educational institution', `institution of higher education',
`prevention', `school', and `youth' have the meanings given to those
terms in section 520E.''; and
(2) NOTE: 42 USC 290bb-36, 290bb-36a. by redesignating
section 520E as section 520E-1.

(c) Youth Suicide and Early Intervention and Prevention
Strategies.--Title V of the Public Health Service Act (42 U.S.C. 290aa
et seq.) is amended by inserting before section 520E-1 (as redesignated
by subsection (b)) the following:
``SEC. 520E. YOUTH NOTE: 42 USC 290bb-36. SUICIDE EARLY
INTERVENTION AND PREVENTION
STRATEGIES.

``(a) NOTE: Contracts. In General.--The Secretary, acting
through the Administrator of the Substance Abuse and Mental Health
Services
Administration, shall award grants or cooperative agreements to eligible
entities to--
``(1) develop and implement State-sponsored statewide or
tribal youth suicide early intervention and prevention
strategies in schools, educational institutions, juvenile
justice systems, substance abuse programs, mental health
programs, foster care systems, and other child and youth support
organizations;
``(2) support public organizations and private nonprofit
organizations actively involved in State-sponsored statewide or
tribal youth suicide early intervention and prevention
strategies and in the development and continuation of State-
sponsored statewide youth suicide early intervention and
prevention strategies;
``(3) provide grants to institutions of higher education to
coordinate the implementation of State-sponsored statewide or
tribal youth suicide early intervention and prevention
strategies;
``(4) collect and analyze data on State-sponsored statewide
or tribal youth suicide early intervention and prevention
services that can be used to monitor the effectiveness of such
services and for research, technical assistance, and policy
development; and
``(5) assist eligible entities, through State-sponsored
statewide or tribal youth suicide early intervention and
prevention strategies, in achieving targets for youth suicide
reductions under title V of the Social Security Act.

``(b) Eligible Entity.--
``(1) Definition.--In this section, the term `eligible
entity' means--
``(A) a State;
``(B) a public organization or private nonprofit
organization designated by a State to develop or direct
the State-sponsored statewide youth suicide early
intervention and prevention strategy; or
``(C) a Federally recognized Indian tribe or tribal
organization (as defined in the Indian Self-
Determination and Education Assistance Act) or an urban
Indian organization (as defined in the Indian Health
Care Improvement Act) that is actively involved in the
development and continuation of a tribal youth suicide
early intervention and prevention strategy.

[[Page 1410]]
118 STAT. 1410

``(2) Limitation.--In carrying out this section, the
Secretary shall ensure that each State is awarded only 1 grant
or cooperative agreement under this section. For purposes of the
preceding sentence, a State shall be considered to have been
awarded a grant or cooperative agreement if the eligible entity
involved is the State or an entity designated by the State under
paragraph (1)(B). Nothing in this paragraph shall be construed
to apply to entities described in paragraph (1)(C).

``(c) Preference.--In providing assistance under a grant or
cooperative agreement under this section, an eligible entity shall give
preference to public organizations, private nonprofit organizations,
political subdivisions, institutions of higher education, and tribal
organizations actively involved with the State-sponsored statewide or
tribal youth suicide early intervention and prevention strategy that--
``(1) provide early intervention and assessment services,
including screening programs, to youth who are at risk for
mental or emotional disorders that may lead to a suicide
attempt, and that are integrated with school systems,
educational institutions, juvenile justice systems, substance
abuse programs, mental health programs, foster care systems, and
other child and youth support organizations;
``(2) demonstrate collaboration among early intervention and
prevention services or certify that entities will engage in
future collaboration;
``(3) employ or include in their applications a commitment
to evaluate youth suicide early intervention and prevention
practices and strategies adapted to the local community;
``(4) provide timely referrals for appropriate community-
based mental health care and treatment of youth who are at risk
for suicide in child-serving settings and agencies;
``(5) provide immediate support and information resources to
families of youth who are at risk for suicide;
``(6) offer access to services and care to youth with
diverse linguistic and cultural backgrounds;
``(7) offer appropriate postsuicide intervention services,
care, and information to families, friends, schools, educational
institutions, juvenile justice systems, substance abuse
programs, mental health programs, foster care systems, and other
child and youth support organizations of youth who recently
completed suicide;
``(8) offer continuous and up-to-date information and
awareness campaigns that target parents, family members, child
care professionals, community care providers, and the general
public and highlight the risk factors associated with youth
suicide and the life-saving help and care available from early
intervention and prevention services;
``(9) ensure that information and awareness campaigns on
youth suicide risk factors, and early intervention and
prevention services, use effective communication mechanisms that
are targeted to and reach youth, families, schools, educational
institutions, and youth organizations;
``(10) provide a timely response system to ensure that
child-serving professionals and providers are properly trained
in youth suicide early intervention and prevention strategies
and that child-serving professionals and providers involved in
early

[[Page 1411]]
118 STAT. 1411

intervention and prevention services are properly trained in
effectively identifying youth who are at risk for suicide;
``(11) provide continuous training activities for child care
professionals and community care providers on the latest youth
suicide early intervention and prevention services practices and
strategies;
``(12) conduct annual self-evaluations of outcomes and
activities, including consulting with interested families and
advocacy organizations;
``(13) provide services in areas or regions with rates of
youth suicide that exceed the national average as determined by
the Centers for Disease Control and Prevention; and
``(14) obtain informed written consent from a parent or
legal guardian of an at-risk child before involving the child in
a youth suicide early intervention and prevention program.

``(d) Requirement for Direct Services.--Not less than 85 percent of
grant funds received under this section shall be used to provide direct
services, of which not less than 5 percent shall be used for activities
authorized under subsection (a)(3).
``(e) Coordination and Collaboration.--
``(1) In general.--In carrying out this section, the
Secretary shall collaborate with relevant Federal agencies and
suicide working groups responsible for early intervention and
prevention services relating to youth suicide.
``(2) Consultation.--In carrying out this section, the
Secretary shall consult with--
``(A) State and local agencies, including agencies
responsible for early intervention and prevention
services under title XIX of the Social Security Act, the
State Children's Health Insurance Program under title
XXI of the Social Security Act, and programs funded by
grants under title V of the Social Security Act;
``(B) local and national organizations that serve
youth at risk for suicide and their families;
``(C) relevant national medical and other health and
education specialty organizations;
``(D) youth who are at risk for suicide, who have
survived suicide attempts, or who are currently
receiving care from early intervention services;
``(E) families and friends of youth who are at risk
for suicide, who have survived suicide attempts, who are
currently receiving care from early intervention and
prevention services, or who have completed suicide;
``(F) qualified professionals who possess the
specialized knowledge, skills, experience, and relevant
attributes needed to serve youth at risk for suicide and
their families; and
``(G) third-party payers, managed care
organizations, and related commercial industries.
``(3) Policy development.--In carrying out this section, the
Secretary shall--
``(A) coordinate and collaborate on policy
development at the Federal level with the relevant
Department of Health and Human Services agencies and
suicide working groups; and

[[Page 1412]]
118 STAT. 1412

``(B) consult on policy development at the Federal
level with the private sector, including consumer,
medical, suicide prevention advocacy groups, and other
health and education professional-based organizations,
with respect to State-sponsored statewide or tribal
youth suicide early intervention and prevention
strategies.

``(f) Rule of Construction; Religious and Moral Accommodation.--
Nothing in this section shall be construed to require suicide
assessment, early intervention, or treatment services for youth whose
parents or legal guardians object based on the parents' or legal
guardians' religious beliefs or moral objections.
``(g) Evaluations and Report.--
``(1) Evaluations by eligible entities.--Not later than 18
months after receiving a grant or cooperative agreement under
this section, an eligible entity shall submit to the Secretary
the results of an evaluation to be conducted by the entity
concerning the effectiveness of the activities carried out under
the grant or agreement.
``(2) Report.--Not later than 2 years after the date of
enactment of this section, the Secretary shall submit to the
appropriate committees of Congress a report concerning the
results of--
``(A) the evaluations conducted under paragraph (1);
and
``(B) an evaluation conducted by the Secretary to
analyze the effectiveness and efficacy of the activities
conducted with grants, collaborations, and consultations
under this section.

``(h) Rule of Construction; Student Medication.--Nothing in this
section or section 520E-1 shall be construed to allow school personnel
to require that a student obtain any medication as a condition of
attending school or receiving services.
``(i) Prohibition.--Funds appropriated to carry out this section,
section 520C, section 520E-1, or section 520E-2 shall not be used to pay
for or refer for abortion.
``(j) Parental consent.--States and entities receiving funding under
this section and section 520E-1 shall obtain prior written, informed
consent from the child's parent or legal guardian for assessment
services, school-sponsored programs, and treatment involving medication
related to youth suicide conducted in elementary and secondary schools.
The requirement of the preceding sentence does not apply in the
following cases:
``(1) In an emergency, where it is necessary to protect the
immediate health and safety of the student or other students.
``(2) Other instances, as defined by the State, where
parental consent cannot reasonably be obtained.

``(k) Relation to Education Provisions.--Nothing in this section or
section 520E-1 shall be construed to supersede section 444 of the
General Education Provisions Act, including the requirement of prior
parental consent for the disclosure of any education records. Nothing in
this section or section 520E-1 shall be construed to modify or affect
parental notification requirements for programs authorized under the
Elementary and Secondary Education Act of 1965 (as amended by the No
Child Left Behind Act of 2001; Public Law 107-110).
``(l) Definitions.--In this section:

[[Page 1413]]
118 STAT. 1413

``(1) Early intervention.--The term `early intervention'
means a strategy or approach that is intended to prevent an
outcome or to alter the course of an existing condition.
``(2) Educational institution; institution of higher
education; school.--The term--
``(A) `educational institution' means a school or
institution of higher education;
``(B) `institution of higher education' has the
meaning given such term in section 101 of the Higher
Education Act of 1965; and
``(C) `school' means an elementary or secondary
school (as such terms are defined in section 9101 of the
Elementary and Secondary Education Act of 1965).
``(3) Prevention.--The term `prevention' means a strategy or
approach that reduces the likelihood or risk of onset, or delays
the onset, of adverse health problems that have been known to
lead to suicide.
``(4) Youth.--The term `youth' means individuals who are
between 10 and 24 years of age.

``(m) Authorization of Appropriations.--
``(1) In general.--For the purpose of carrying out this
section, there are authorized to be appropriated $7,000,000 for
fiscal year 2005, $18,000,000 for fiscal year 2006, and
$30,000,000 for fiscal year 2007.
``(2) Preference.--If less than $3,500,000 is appropriated
for any fiscal year to carry out this section, in awarding
grants and cooperative agreements under this section during the
fiscal year, the Secretary shall give preference to States that
have rates of suicide that significantly exceed the national
average as determined by the Centers for Disease Control and
Prevention.''.

(d) Mental and Behavioral Health Services on Campus.--Title V of the
Public Health Service Act (42 U.S.C. 290aa et seq.) is amended by
inserting after section 520E-1 (as redesignated by subsection (b)) the
following:
``SEC. 520E-2. MENTAL NOTE: 42 USC 290bb-36b. AND BEHAVIORAL
HEALTH SERVICES ON
CAMPUS.

``(a) In General.--The Secretary, acting through the Director of the
Center for Mental Health Services, in consultation with the Secretary of
Education, may award grants on a competitive basis to institutions of
higher education to enhance services for students with mental and
behavioral health problems that can lead to school failure, such as
depression, substance abuse, and suicide attempts, so that students will
successfully complete their studies.
``(b) Use of Funds.--The Secretary may not make a grant to an
institution of higher education under this section unless the
institution agrees to use the grant only for--
``(1) educational seminars;
``(2) the operation of hot lines;
``(3) preparation of informational material;
``(4) preparation of educational materials for families of
students to increase awareness of potential mental and
behavioral health issues of students enrolled at the institution
of higher education;

[[Page 1414]]
118 STAT. 1414

``(5) training programs for students and campus personnel to
respond effectively to students with mental and behavioral
health problems that can lead to school failure, such as
depression, substance abuse, and suicide attempts; or
``(6) the creation of a networking infrastructure to link
colleges and universities that do not have mental health
services with health care providers who can treat mental and
behavioral health problems.

``(c) Eligible grant recipients.--Any institution of higher
education receiving a grant under this section may carry out activities
under the grant through--
``(1) college counseling centers;
``(2) college and university psychological service centers;
``(3) mental health centers;
``(4) psychology training clinics; or
``(5) institution of higher education supported, evidence-
based, mental health and substance abuse programs.

``(d) Application.--An institution of higher education desiring a
grant under this section shall prepare and submit an application to the
Secretary at such time and in such manner as the Secretary may require.
At a minimum, the application shall include the following:
``(1) A description of identified mental and behavioral
health needs of students at the institution of higher education.
``(2) A description of Federal, State, local, private, and
institutional resources currently available to address the needs
described in paragraph (1) at the institution of higher
education.
``(3) A description of the outreach strategies of the
institution of higher education for promoting access to
services, including a proposed plan for reaching those students
most in need of mental health services.
``(4) A plan to evaluate program outcomes, including a
description of the proposed use of funds, the program
objectives, and how the objectives will be met.
``(5) NOTE: Reports. An assurance that the institution
will submit a report to the Secretary each fiscal year on the
activities carried out with the grant and the results achieved
through those activities.

``(e) Requirement of Matching Funds.--
``(1) In general.--The Secretary may make a grant under this
section to an institution of higher education only if the
institution agrees to make available (directly or through
donations from public or private entities) non-Federal
contributions in an amount that is not less than $1 for each $1
of Federal funds provided in the grant, toward the costs of
activities carried out with the grant (as described in
subsection (b)) and other activities by the institution to
reduce student mental and behavioral health problems.
``(2) Determination of amount contributed.--Non-Federal
contributions required under paragraph (1) may be in cash or in
kind. Amounts provided by the Federal Government, or services
assisted or subsidized to any significant extent by the Federal
Government, may not be included in determining the amount of
such non-Federal contributions.
``(3) Waiver.--The Secretary may waive the requirement
established in paragraph (1) with respect to an institution

[[Page 1415]]
118 STAT. 1415

of higher education if the Secretary determines that
extraordinary need at the institution justifies the waiver.

``(f) Reports.--For each fiscal year that grants are awarded under
this section, the Secretary shall conduct a study on the results of the
grants and submit to the Congress a report on such results that includes
the following:
``(1) An evaluation of the grant program outcomes, including
a summary of activities carried out with the grant and the
results achieved through those activities.
``(2) Recommendations on how to improve access to mental and
behavioral health services at institutions of higher education,
including efforts to reduce the incidence of suicide and
substance abuse.

``(g) Definition.--In this section, the term `institution of higher
education' has the meaning given such term in section 101 of the Higher
Education Act of 1965.
``(h) Authorization of Appropriations.--For the purpose of carrying
out this section, there are authorized to be appropriated $5,000,000 for
fiscal year 2005, $5,000,000 for fiscal year 2006, and $5,000,000 for
fiscal year 2007.''.

Approved October 21, 2004.

LEGISLATIVE HISTORY--S. 2634:
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CONGRESSIONAL RECORD, Vol. 150 (2004):
July 8, considered and passed Senate.
Sept. 8, considered in House.
Sept. 9, considered and passed House, amended. Senate
concurred in House amendment.